Low numbers of smokers, lower rates of obesity and crime all contribute to making Dukes County the second healthiest county in the state. The Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute released rankings on Wednesday.

For the second year in a row Dukes County comes out on top in a statewide health ranking. Islanders, it seems, have low rates of premature death and obesity, and the Vineyard rates high when it comes to recreational facilities and low in fast-food options. But in some health measures, the picture is not so rosy. Dukes County (which consists of Martha’s Vineyard and the Elizabeth Islands) had the highest number of residents reporting excessive drinking, and the highest number of those uninsured.

The absence of fast food on the Island rankles some but it may also mean we are healthier. Vineyard residents rank as the healthiest in the state, according to a survey released Tuesday by the University of Wisconsin and the Robert Wood Johnson Foundation. Nantucket ranks second, the report found.